Gastroenterology Research and Practice最新文献

{"title":"Correlation between Preoperative Platelet Count/(Lymphocyte Count × Prealbumin Count) Ratio and the Prognosis of Patients with Gastric Cancer Undergoing Radical Operation.","authors":"Yi Liu, Yanguang Yang, Guomei Tai, Feng Ni, Cenming Yu, Wenjing Zhao, Ding Wang","doi":"10.1155/2023/8401579","DOIUrl":"https://doi.org/10.1155/2023/8401579","url":null,"abstract":"<p><strong>Objective: </strong>To clarify the relationship between preoperative platelet count/(lymphocyte count × prealbumin count) ratio (PLPR) and the prognosis of patients with gastric cancer undergoing a radical operation, combined with Tumor Node Metastasis (TNM) staging, a scoring system was established to guide clinical application.</p><p><strong>Methods: </strong>The clinical data of 238 patients receiving radical operations for gastric cancer were retrospectively analyzed. According to the area under the Receiver operating characteristic curve, the predictive value of the preoperative PLPR for the 5-year overall survival (OS) of gastric cancer was determined, and the best cut-off value of the ratio was corresponding to the maximum value of Yoden index. Chi-squared test was applied to analyze the correlation between the ratio and clinicopathological features. Kaplan-Meier curve was applied to analyze the influence of this ratio on 5-year OS. The Cox regression model was applied to analyze the hazards affecting the long-term survival of patients. The nomogram model was used to predict the long-term survival rate.</p><p><strong>Results: </strong>The optimal cut-off point of preoperative PLPR ratio was 7.46, and the patients were segmented into two sets: one set of ratio <7.46 and another set of ratio ≥7.46. The ratio was correlated with the size of the tumor, T stage, N stage, total stage, vascular cancer thrombus, and nerve invasion. In stage I-III patients, the prognosis was better in the low-ratio set than in the high-ratio set (<i>P</i> < 0.001), subgroup analysis indicated the prognosis was obviously better in the low-ratio set than in the high-ratio set in stage II and III patients (<i>P</i> < 0.05 and <i>P</i> < 0.001), but there was no difference in stage I patients (<i>P</i> > 0.05). Age, T stage, N stage, total TNM stage, tumor size, vascular tumor thrombus, nerve invasion, preoperative neutrophil count/lymphocyte count (NLR; reference value 3.68), preoperative PLPR (reference value 7.46), preoperative platelet count/lymphocyte count (PLR; reference value 159.56), and preoperative platelet count × NLR (SII; reference value 915.48) were related to patient prognosis (<i>P</i> < 0.05); meanwhile age, total TNM stage, preoperative PLPR (reference value 7.46), preoperative PLR (reference value 159.56), and preoperative SII (reference value 915.48) were independent hazards for prognosis (<i>P</i> < 0.05). Five independent risk factors were analyzed by nomogram model to predict the 5-year OS of patients who underwent a radical operation for carcinoma of the stomach.</p><p><strong>Conclusion: </strong>Preoperative PLPR ratio (reference value 7.46) is an independent risk factor for long-term prognosis in patients undergoing a radical operation for gastric cancer. The nomogram scoring system established by postoperative TNM staging combined with this ratio and age, PLR, and SII can better forecast the survival of patients who underwent rad","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":"2023 ","pages":"8401579"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10403323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10308278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Distribution Characteristics and Identification for Significant Liver Inflammation of Patients in Chronic Hepatitis B with Indeterminate Phase.","authors":"Shanshan Chen,&nbsp;Xuan Dai,&nbsp;Yueyue Zhao,&nbsp;Jie Li,&nbsp;Xuehan Zou,&nbsp;Haijun Huang","doi":"10.1155/2023/7264601","DOIUrl":"https://doi.org/10.1155/2023/7264601","url":null,"abstract":"<p><strong>Aim: </strong>In clinical practice, a considerable proportion of patients with chronic hepatitis B (CHB) who do not conform to any immune status are considered to be in the \"indeterminate phase\". In this study, we aim to study the clinical distribution characteristics and identification of significant liver inflammation in patients in indeterminate phase.</p><p><strong>Methods: </strong>This study retrospectively analyze clinical data of 1226 patients with CHB at two medical centers in Zhejiang province. According to American Association for the Study of Liver Diseases (AASLD) 2018 hepatitis B guidance, CHB can be divided into four phases: immune-tolerant phase, HBeAg-positive immune active phase, inactive phase, and HBeAg-negative immune active phase. Liver inflammation grade was evaluated using the Scheuer scoring system, and significant liver inflammation was defined as <i>G</i> ≥ 2.</p><p><strong>Results: </strong>The distribution of different immune status was as follows: 259 (21.1%) patients in immune-tolerant phase, 365 (29.8%) patients in HBeAg-positive immune active phase, 128 (10.4%) patients in inactive phase, and 33 (2.7%) patients in HBeAg-negative immune active phase. However, 441 (36.0%) patients did not meet any of the above immune phases, which were defined as indeterminate phase. Significant liver inflammation (54.1%) was common in CHB patients with indeterminate phase. Prothrombin time (PT), platelet count (PLT), alanine aminotransferase (ALT), and hepatitis B virus (HBV)-DNA were associated with significant inflammation.</p><p><strong>Conclusions: </strong>The results of this study showed that about 36.0% of patients were divided into indeterminate phase. The proportion of patients with significant inflammation in indeterminate phase and liver inflammation becomes more severe with aggravation of fibrosis stage. PT, PLT, ALT, and HBV-DNA may have a significant correlation with severe inflammation and prognosis of CHB.</p>","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":"2023 ","pages":"7264601"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10353904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10202741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy of Surgical Resection versus Radiofrequency Ablation for the Treatment of Single Hepatocellular Carcinoma: A SEER-Based Study.","authors":"Fang Wu,&nbsp;Chao Wei,&nbsp;Shicun Zhang,&nbsp;Shanshan Jia,&nbsp;Jidong Zhang","doi":"10.1155/2023/1269504","DOIUrl":"https://doi.org/10.1155/2023/1269504","url":null,"abstract":"<p><strong>Background: </strong>There is controversy regarding whether patients with single hepatocellular carcinoma (HCC) should be offered radiofrequency ablation (RFA) as a first-line treatment option. Thus, this study compared overall survival after surgical resection (SR) and RFA for single HCC.</p><p><strong>Methods: </strong>The Surveillance, Epidemiology, and End Results (SEER) database was used for this retrospective study. The study included 30- to 84-year-old patients diagnosed with HCC from 2000 to 2018. Selection bias was reduced via propensity score matching (PSM). The study compared the overall survival (OS) and cancer-specific survival (CSS) of patients with single HCC who were treated with SR and RFA.</p><p><strong>Results: </strong>Before and after PSM, the median OS and median CSS were significantly longer in the SR group than in the RFA group (<i>p</i> < 0.05). In the subgroup analysis, the median OS and median CSS for male and female patients with male and female patients with tumor sizes <3, 3-5, and>5 cm, age at diagnosis between 60 and 84 years, and grades I-IV tumors were longer than in the SR group than in the RFA group (<i>p</i> < 0.05). Similar results were reported for patients who received chemotherapy (<i>p</i> < 0.05). Univariate and multivariate analyses revealed that compared with RFA, SR was an independent favorable factor for OS and CSS (<i>p</i> < 0.05) before and after PSM.</p><p><strong>Conclusion: </strong>Patients with SR who had a single HCC showed higher OS and CSS compared with patients who received RFA. Hence, SR should be used as a first-line treatment in cases of single HCC.</p>","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":"2023 ","pages":"1269504"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9974275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10823896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Gastrointestinal Bleeding in Patients with End-Stage Renal Disease: The Link between Gut, Heart, and Kidneys.","authors":"Avleen Kaur,&nbsp;Syed M Baqir,&nbsp;Kundan Jana,&nbsp;Kalyana C Janga","doi":"10.1155/2023/9986157","DOIUrl":"https://doi.org/10.1155/2023/9986157","url":null,"abstract":"<p><p>Patients with end-stage renal disease (ESRD) have a five times higher risk of gastrointestinal bleed (GIB) and mortality than the general population. Aortic stenosis (AS) has been associated with GIB from intestinal angiodysplasia. In this retrospective analysis, we obtained data from the 2012 and 2019 National Inpatient Sample. The primary outcome of interest was all-cause in-hospital mortality and risk factors of mortality in patients with ESRD with GIB with aortic valve disorders especially AS. We identified all patients (≥18 years of age) with ESRD (<i>n</i> = 1,707,452) and analyzed based on discharge diagnosis of valvular heart disease (<i>n</i> = 6521) in patients with GIB compared with those without GIB (<i>n</i> = 116,560). Survey statistical methods accounting for strata and weighted data were used for analysis using survey packages in R (version 4.0). Baseline categorical data were compared using Rao-Scott chi square test, and continuous data were compared using Student's <i>t</i>-test. Covariates were assessed using univariate regression analysis, and factors with <i>p</i> value less than 0.1 in the univariate analysis were entered in the final model. The univariate and multivariable associations of presumed risk factors of mortality in ESRD with GIB patients were performed by Cox proportional hazards model censored at length of stay. Propensity score matching was done using MatchIt package in R (version 4.3.0). 1 : 1 nearest neighbour matching was done with propensity scores estimated through logistic regression, in which occurrence of GIB, valvular lesions, and AS was regressed according to other patient characteristics. Among patients with ESRD with valvular heart diseases, AS was found to be associated with increased risk of GIB (adj.OR = 1.005; 95% CI 1.003-1.008; <i>p</i> < 0.01). ESRD patients with AS showed increased risk of lower GIB (OR = 1.04; 95% CI 1.01-1.06; <i>p</i> = 0.02), colonic angiodysplasia (OR = 1.03; 95% CI 1.01-1.05; <i>p</i> < 0.01), stomach and duodenal angiodysplasia (OR = 1.03; 95% CI 1.02-1.06; <i>p</i> < 0.01), need for blood transfusion add pressors as compared to those without AS. However, there was no increased risk of mortality (OR = 0.97; 95% CI 0.95-0.99; <i>p</i> < 0.01).</p>","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":"2023 ","pages":"9986157"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10185431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9491743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Gastric Cancer Risk Classifications Using Conventional and New Pepsinogen Criteria.","authors":"Tae Sasakabe,&nbsp;Yuki Obata,&nbsp;Sayo Kawai,&nbsp;Yingsong Lin,&nbsp;Shogo Kikuchi","doi":"10.1155/2023/7646536","DOIUrl":"https://doi.org/10.1155/2023/7646536","url":null,"abstract":"<p><strong>Background: </strong>New serum pepsinogen (PG) criteria have been shown to indicate more accurately infection with <i>Helicobacter pylori</i> (<i>H. pylori</i>). We sought to improve risk classification for gastric cancer by adopting the new PG criteria with the addition of an <i>H. pylori</i> antibody test.</p><p><strong>Methods: </strong>The study participants were 275 patients with gastric cancer and 275 apparently healthy controls from case-control study data. We cross-sectionally compared the results of gastric cancer risk classifications that were based on a combination of the new PG criteria (PG II ≥ 10 ng/mL or PG I/II ≤ 5) and an <i>H. pylori</i> antibody test with those that were based on a combination of the conventional criteria (PG I ≤ 70 ng/mL and PG I/PG II ≤ 3) and an <i>H. pylori</i> antibody test.</p><p><strong>Results: </strong>Applying the conventional criteria resulted in 89 controls being classified as low risk. Applying the new criteria resulted in 23 controls (bootstrapped 95% confidence intervals [CI]: 14, 32) being additionally classified as high risk. Eight patients with gastric cancer were classified as low risk using the conventional criteria; however, six of these patients were classified as high risk by the new criteria (bootstrapped 95% CI: 2, 11).</p><p><strong>Conclusions: </strong>Compared with the conventional criteria, the new PG criteria with <i>H. pylori</i> antibody reduced instances of gastric cancer cases being misclassified as low risk. These findings suggest that the new PG criteria may help identify individuals at high risk of developing gastric cancer.</p>","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":"2023 ","pages":"7646536"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10243942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9653010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Esophageal Lymphoma: A Histopathological Experience from Two Tertiary Hospitals, Western Saudi Arabia.","authors":"Jaudah Al-Maghrabi,&nbsp;Sahar Al-Maghrabi","doi":"10.1155/2023/7302344","DOIUrl":"https://doi.org/10.1155/2023/7302344","url":null,"abstract":"<p><strong>Background: </strong>Primary esophageal lymphoma (PEL) is a rare disorder. The objective of this study was to document the clinicopathological features of PEL at two tertiary hospitals in the western region of the Kingdom of Saudi Arabia.</p><p><strong>Methods: </strong>All PELs diagnosed between May 2002 and June 2022 were retrieved. Histopathological and immunohistochemical slides were reviewed. Additional immunohistochemistry stains were performed in selected cases. Follow-up data were collected.</p><p><strong>Results: </strong>There were only eight cases of PEL in the records of the two hospitals. The age of the patients ranged between 50 and 74 years (median 62 years and mean 62.5 years). There were six males (80%) and two females (20%). None of the patients were immunocompromised or had human immunodeficiency virus (HIV) infection. The clinical manifestation included dysphagia and loss of weight. Six cases were diffuse large B-cell lymphoma (DLBCL), and two were low-grade mucosa-associated lymphoid tissue lymphoma.</p><p><strong>Conclusion: </strong>PEL is an extremely rare disease with male predominance. DLBCL is the most common pathological type in our community. There was no relation to immune status or HIV infection in this series. Clinical presentations were typically dysphagia with weight loss. Further reporting of PEL cases might help explain this disease and improve its diagnosis and management.</p>","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":"2023 ","pages":"7302344"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9902162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10689661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EMP1 as a Potential Biomarker in Liver Fibrosis: A Bioinformatics Analysis.","authors":"Xuchen Chen,&nbsp;Xinliang Lv,&nbsp;Manman Han,&nbsp;Yexiao Hu,&nbsp;Wanqiong Zheng,&nbsp;Haibo Xue,&nbsp;Zhuokai Li,&nbsp;Kui Li,&nbsp;Wei Tan","doi":"10.1155/2023/2479192","DOIUrl":"https://doi.org/10.1155/2023/2479192","url":null,"abstract":"<p><p>Liver fibrosis is a wound-healing response to chronic injury, which may result in cirrhosis and liver failure. Studies have been carried on the mechanisms and pathogenesis of liver fibrosis. However, the potential cell-specific expressed marker genes involved in fibrotic processes remain unknown. In this study, we combined a publicly accessible single-cell transcriptome of human liver with microarray datasets to evaluate the cell-specific expression patterns of differentially expressed genes in the liver. We noticed that <i>EMP1</i> (epithelial membrane protein 1) is significantly active not only in CCl₄ (carbon tetrachloride)-treated mouse liver fibrosis but also in BDL (bile duct ligation)-induced liver fibrosis and even in human fibrotic liver tissues such as alcoholic hepatitis, NASH (nonalcoholic steatohepatitis), and advanced stage liver fibrosis. Furthermore, we demonstrated that EMP1 is a specific fibrotic gene expressed in HSCs (hepatic stellate cells) and endothelial cells using the Protein Atlas single-cell transcriptome RNA-sequencing clustering. Its expression was significantly elevated in fibrotic HSCs or CCl₄ and NASH-induced fibroblasts. Previous research revealed that <i>EMP1</i> plays a role in proliferation, migration, metastasis, and tumorigeneses in different cancers via a variety of mechanisms. Because HSC activation and proliferation are two important steps following liver injury, it would be interesting to investigate the role of EMP1 in these processes. All of this information suggested that EMP1 could be used as a novel fibrotic liver marker and a possible target in the future.</p>","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":"2023 ","pages":"2479192"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10060069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9595993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Assessment of Patients Undergoing Bariatric Sleeve Gastrectomy: A Cross-Sectional Study.","authors":"M R Tawfik, N F Aldawas, N S Almegbil, A A Bin Hamad, A N Alanazi, A M Alaidaroos, T M AlRawaf, A A Fayed","doi":"10.1155/2022/3622119","DOIUrl":"10.1155/2022/3622119","url":null,"abstract":"<p><strong>Introduction: </strong>Saudi Arabia (SA) is one of the top countries in the world when it comes to the number of bariatric procedures performed each year. There is still some debate on whether to do regular or selective upper endoscopy during the preoperative examination. The purpose of this study was to explore various endoscopic findings and Helicobacter pylori (HP) infection in symptomatic and asymptomatic patients having laparoscopic sleeve gastrectomy (LSG) prior to surgery.</p><p><strong>Methods: </strong>We investigated a cohort of 132 patients referred to the endoscopy unit from the bariatric surgery outpatient clinic for prebariatric esophagogastroduodenoscopy (EGD) as a part of preoperative LSG. Data extraction from medical records included clinical data such as body mass index (BMI), gastrointestinal symptoms (that include heartburn, regurgitation, epigastric pain, and nausea), medical comorbidities, and laboratory investigations. It included data about the endoscopic findings of EGD procedure as esophageal, gastric, and duodenal findings results as well as the results of biopsy specimens that were taken.</p><p><strong>Results: </strong>Out of 132 patients, 29 (22%) had a BMI of less than 40 kg/m² whereas 103 (78%) had a BMI of 40 kg/m² or above, with an average of 44.4 ± 6.4 kg/m². The average age of participants was 33.6 ± 10.4 years. HP was detected in 36 patients (35.0%) with a slightly greater prevalence in patients with a higher BMI (33.7%) than in patients with lower BMI (35.0%). Collectively, 73 patients (55.7%) had positive endoscopic findings of various grades, sites, and combinations. Incompetent cardia (35.6%) was the most often seen esophageal finding, antral gastritis (34.1%) was the most frequently encountered gastric finding, and duodenitis 1st part was the commonest duodenal endoscopic finding (7.8%). Among asymptomatic patients, incompetent cardia was detected in 33.3%, antral gastritis was found in 30.1%, and around one-quarter of them were positive on HP testing (26.6%). Additionally, 16.1% of them had signs of reflux esophagitis, 17.2% had hiatal hernia, and 14.0% had nodular gastritis.</p><p><strong>Conclusion: </strong>The current study revealed a high prevalence of positive endoscopic findings as well as HP infection upon routine endoscopic examination among patients undergoing bariatric surgery even those who were asymptomatic from any gastrointestinal symptoms.</p>","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":"1 1","pages":"3622119"},"PeriodicalIF":2.0,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42615314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors of Early Liver Metastasis for Pancreatic Ductal Adenocarcinoma after Radical Resection","authors":"Jingshu Tong, Shengdong Wu, Changjiang Lu, Yong Yang, S. Mao, Caide Lu","doi":"10.1155/2022/8061879","DOIUrl":"https://doi.org/10.1155/2022/8061879","url":null,"abstract":"Background Liver metastasis arises in many postoperative patients with PDAC, occurring in the early stage appears to lead to a very poor prognosis. Objective We aimed to analyze the risk factors for early liver metastasis after radical resection for patients with pancreatic ductal adenocarcinoma (PDAC) and to indicate the poor prognosis of early liver metastasis. Methods Patients who underwent pancreatectomy for PDAC at the Ningbo Medical Centre Lihuili Hospital between January 2015 and June 2021 were included. The exclusion criteria were death within 30 days after the operation, complications with other malignancies, and a positive final resection margin (R1). Liver metastasis and its occurrence time were recorded, and risk factors for early (≤6 months) liver metastasis were analyzed by logistic regression models. The prognosis of patients with early liver metastasis and different recurrence patterns was analyzed by Kaplan–Meier curves and the log-rank test. Results From the identified cohort of 184 patients, 172 patients were included for further analysis. 55 patients developed early liver metastasis within 6 months after the operation. Univariate analysis showed that CA125 ≥ 30 IU/ml, tumor size ≥ 4 cm, poor tumor differentiation, and portal vein/superior mesenteric vein (PV/SMV) reconstruction were risk factors, and multivariate analysis showed that poor tumor differentiation and PV/SMV reconstruction were independent risk factors for early liver metastasis. The prognosis of liver metastasis was the worst among the different recurrence patterns. Early liver metastasis indicates a poor prognosis in patients with PDAC. Conclusions Poor differentiation and PV/SMV reconstruction are independent risk factors for early liver metastasis in patients with PDAC, and early liver metastasis indicates a poor prognosis.","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47483790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiation of Isolated Small Bowel Crohn's Disease from Other Small Bowel Ulcerative Diseases: Clinical Features and Double-Balloon Enteroscopy Characteristics","authors":"Meng Niu, Zhenghao Chen, Meng Li, Xing-Long Zhang, C. Chen","doi":"10.1155/2022/5374780","DOIUrl":"https://doi.org/10.1155/2022/5374780","url":null,"abstract":"Background The diagnosis of isolated small bowel Crohn's disease (ISBCD) has always been challenging. Aims This study is aimed at comparing the clinical features and double-balloon enteroscopy (DBE) characteristics of ISBCD with those of other small bowel ulcerative diseases (OSBUD). Methods Patients with coexisting colonic and/or ileal valve lesions (n = 45) or whose final diagnosis was not determined (n = 29) were excluded. One hundred thirty-nine patients with ISBCD and 62 patients with OSBUD found by DBE were retrospectively analyzed. Results The age of ISBCD onset was lower than that of OSBUD (OR 0.957, 95% CI 0.938-0.977, p < 0.001). Abdominal pain was more common in ISBCD (OR 4.986, 95% CI 2.539-9.792, p < 0.001). Elevated fibrinogen levels (OR 1.431, 95% CI 1.022-2.003, p = 0.037) and lower levels of D-dimer (OR 0.999, 95% CI 0.999-1.000, p = 0.017) were also more supportive of the diagnosis of ISBCD. Nonsteroidal anti-inflammatory drugs (NSAIDs) used for more than two weeks decreased the probability of a diagnosis of ISBCD (OR 0.173, 95% CI 0.043-0.695, p = 0.013). Abdominal computed tomography revealed a higher proportion of skip lesions in ISBCD than in OSBUD (OR 9.728, 95% CI 3.676-25.742, p < 0.001). The ulcers of ISBCD were more distributed in the ileum (111 (79.9%) vs. 29 (46.8%), p < 0.001), and their main morphology differed in different intestinal segments. Longitudinal ulcers (OR 14.293, 95% CI 4.920-41.518, p < 0.001) and large ulcer (OR 0.128, 95% CI 0.044-0.374, p < 0.001) contributed to the differentiation of ISBCD from OSBUD. We constructed a diagnostic model, ISBCD index (AUROC = 0.877, 95% CI: 0.830-0.925), using multifactorial binary logistic regression to help distinguish between these two groups of diseases. Conclusion Clinical features, laboratory tests, abdominal computed tomography, DBE characteristics, and pathology help to distinguish ISBCD from OSBUD.","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42471758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}